Chris Lancelot: More slow lane than information superhighway

Why is everything in the NHS so complex, fiddly and time-consuming? Despite the vast amounts of money spent on NHS computing, nothing seems truly joined up. Yes, the IT works - after a fashion. But it's nothing like as smooth as it could be.

So how about the following? Rather than having a separate login for each program on our workstations, why doesn't the DoH insist that they should be integrated, so that a single login gives instant access to the clinical system, Choose and Book, NHS mail, the PCT's website ...? Being able to move seamlessly between different parts of the NHS would reduce irritation and save time.

The NHS is moving towards exclusive electronic referrals - so why are individual outpatient departments still allowed to produce paper proformas? The DoH should insist that all proformas are electronic, allowing patient details to be filled in automatically by the practice computer. This would save time, remove transcription errors, and improve form legibility.

Why do careless managers send out documentation by the megabyte, routinely including large numbers of pretty pictures, logos and diagrams, all of which clog up our email systems? Hardly anyone reads them immediately. The time they are actually read is when someone needs the information - and by then it may well be out of date.

The DoH should insist that all NHS, PCT and PBC documents are placed on central web-based repositories, with only a link to these documents being emailed out, rather than the documents themselves. Now there would be just one place to look for the information; only one place for managers to amend it; and users would only look at it when they needed it, but when they did they would always get the latest version. Efficient, precise and up to date - instantly removing the information clutter.

None of this is difficult to implement: it could all have been carried out long ago. There are many more examples, all demonstrating that the DoH hasn't grasped the importance of making users' lives easier through simplifying and joining up its IT. Clearly it doesn't value primary care enough to spend time and effort making NHS computing user-friendly. Well, now we know.

Dr Lancelot is a GP from Lancashire


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